| NPI | 1750347282 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: PA OS023315) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MD H0052365) |
| Enumeration Date | 2006-04-24 |
| Last Update Date | 2024-06-10 |